Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome.
Wuang YP, Chiang CS, Su CY, Wang CC.
Department of Occupational Therapy, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. firstname.lastname@example.org
This quasi-experimental study compared the effect of standard occupational therapy (SOT) and virtual reality using Wii gaming technology (VRWii) on children with Down syndrome (DS). Children (n = 105) were randomly assigned to intervention with either SOT or VRWii, while another 50 served as controls. All children were assessed with measures of sensorimotor functions. At post-intervention, the treatment groups significantly outperformed the control group on all measures. Participants in the VRWii group had a greater pre-post change on motor proficiency, visual-integrative abilities, and sensory integrative functioning. Virtual reality using Wii gaming technology demonstrated benefit in improving sensorimotor functions among children with DS. It could be used as adjuvant therapy to other proven successful rehabilitative interventions in treating children with DS.
Here is a big section of the discussion section of the paper. Basically, Standard Occupational Therapy (SOT) helps Down Syndrome (DS) kids do better on fine and gross motor skills. Using Virtual Reality Wii seems to help even more. Gotta love that.
Of the two intervention groups, children who received VRWii therapy demonstrated the largest increase in post-intervention scores on the BOT-2 gross motor subtests. Significant improvement in gross motor function may be accounted for by the accumulated effects from a series of training steps that are structured, progressive, goal-directed, and interrelated. For instance, once the child initially learned to maintain equilibrium on VRWii Sports items, more challenging dynamic tasks such as jumping, striking and catching balls were introduced. VRWii could allow the child to interact with a computer-simulated environment and receive near real-time augmented feedback on performance. After mastering the VRWii tasks, the child was better able to use body feedback to understand the movement outcomes (feedback), anticipate upcoming events (feedforward), and plan alternative strategies (Brooks, 1986). Simultaneously, the child was encouraged to rely more on internal feedback and self-evaluation of performance than external feedback from others and environment. By adjusting the difficult level of Wii Sport items, more mature patterns of motor control emerged from better use of feedback and feedforward mechanisms.
The VRWii group achieved the greatest progress primarily in the BOT-2 fine motor subtests as well. A probable explanation is that success with skilled fine motor tasks relies upon sophisticated motor control and higher-level motor planning. The nature of VRWii therapy promotes an optimal sensory intake by allowing the child to actively explore and organize diverse sensory inputs. An overall improved organization of sensory input may subsequently enhance motor planning and sequencing ability, thereby leading to the improvement in fine motor skills (Humphries, Wright, Snider, & McDougall, 1992). In addition, the improvement in hand function also depended on the child’s ability to modify the patterns of grasping Wii handle according to the different somatosensory input from diverse VRWii Sport items. An essential component of all extremities movements experienced in VRWii Sports is proactive visual and somatosensory control ([Augurelle et al., 2003], Jeannerod, 1986 M. Jeannerod, The formation of finger grip during prehension: A cortically mediated visuomotor pattern, Behavior and Brain Research 19 (1986), pp. 99–116. Abstract | PDF (1331 K) | View Record in Scopus | Cited By in Scopus (130)[Jeannerod, 1986] and [Jeannerod, 1990]), which is responsible for the correct execution of limb movement and the coordination between limbs and vision ([Johansson, 1996] and [Whitney and Wrisley, 2004]). Therefore, tasks involved with visual motor integration of VMI and BOT-2 were also improved by VRWii.
Unexpectedly, the VRWii group alone demonstrated larger increase in all TSIF subtest scores post intervention than SOT that included sensory integration therapy. This result offers direct evidence that children with DS are able to benefit from VRWii therapy to optimize the integrated processing of sensory cues and motor responses. VRWii itself could provide constant opportunities for children to integrate visual, vestibular, and proprioceptive inputs. In particular, significant gains in emotion and behavior subtest of the TSIF after VRWii intervention implies that the playfulness inherent in the VRWii items was able to tap into the children’s inner drive to engage with VRWii therapy. By actively participating in the goal-directed and enjoyable activities, the therapeutic effects could be maximized ([Larin, 2000] and [Parham and Mailloux, 2010]), and the psychosocial needs of children were fulfilled as well (Tye & Tye, 1992). The principle of Wii by using self-initiation, meaningful, and challenging activities in increasing neural plasticity coincided with the principles of sensory integration theory proposed by Ayres ([Ayres, 1972] and [Jacobs and Schenider, 2001]).
All about the right tools. Very interested in the Kinect as well. Thanks for this.